Some Uses of Narcissism CONTINUED

Time and again, the “Me-Decade social critics” she is writing about are dismissed in this way. Again, if they are so hopeless, why talk about them at all? And if they have some substance, even if there is something debatable in what they write, why not flesh it out more? In this example, of course, to dismiss the role of culture in the expression of narcissism is to dismiss the critique of capitalism on which the argument is based. But it is clear throughout the book that Lasch has no chance: the whole point of the book is that Lasch is irrelevant.

By the time we get to the concluding chapter of the book, it is not hard to make a case for how Lunbeck (2014) is using narcissism when she quotes The New York Times columnist David Brooks, who lamented “that ‘grandiosity is out of style’”:

Collectively chastened by a financial crisis that was “fueled by people who got too big for their britches,” Brooks argues that we have traded boldness for caution, and calls for “a grandiosity rebound” to encourage the unpleasant, “ridiculously ambitious” people who can revive the nation’s once-formidable prosperity. “Most of all,” he writes in a challenge to the Laschians still among us, “there has to be a culture that gives two cheers to grandiosity,” even as he highlights the character flaws and limitations of the grandiose. Bold and creative, ruthless and soulless: Brooks’ cultural ideal, the entrepreneurial wizard as twenty-first-century narcissist, “has the vices of his virtues”. (Lunbeck, 2014, p. 253)

Brooks (2012) was of course lamenting the aftereffects of the global recession of 2007-2008. This is the only place in her argument where Lunbeck mentions the financial crisis, but the existence of the financial crisis does offer an answer to my earlier question, why this book would be written now. She goes on to praise as model narcissists specifically Steve Jobs and Jack Welch. Here at the end, again, the point seems to be mostly that something can be thought of as a problem by people like Lasch, but really not be a problem at all. The “narcissistic” pursuit of pleasure is inextricably bound up in Lunbeck and Brooks’ reading with extreme wealth—but is it a problem, or is it just progress? “Progress is a moral judgement by a creature that loves to regard itself in the mirror” observes Paul Verhaeghe (2012/2014, p. 60), and one may infinitely rethink one’s judgments.

But this is also a great example of how one may “use” narcissism. In this sense, Lunbeck’s book is an example of what Lasch and Ovid would call narcissistic, precisely because it is entirely focused on image. There is no problem addressed in the book that is not simply a matter of how one looks at it: that the “grandiosity,” as Brooks calls it, of the wealthy and ruthless may have played a part in the Great Recession is not relevant to Lunbeck’s argument. In the end, Lunbeck simply assumes that “healthy narcissism” is a characteristic of those who are most successful in the neoliberal economy simply because they are the most successful. Several times she makes the claim that Steve Jobs and Jack Welsh et al., the “ridiculously grand,” as Brooks (Lunbeck, 2014, quoted p. 254) called them, “are necessary,” without questioning why that is so. It is the image of the wildly successful that proves their necessity for the rest of us. However, Paul Verhaeghe, in his own recent study of narcissism and late capitalism (again, it is striking how these two topics seem to come together these days), discusses research that provides evidence that “[t]oo much economic inequality leads to a loss of respect, including self-respect—and, in psychosocial terms, this is about the worst thing that can happen to anyone” (2012/2014, p. 198). So, it would seem that there really is a problem at some level. Image is not everything.

Kate Schechter’s Illusions of a Future (2014), published in the same year as Lunbeck’s book, also won the Courage to Dream prize from the American Psychoanalytic Association, though her work did not elicit the interest of the non-specialist media that Lunbeck’s received. Even in the Journal of the American Psychoanalytic Association, where it was reviewed in tandem with Lunbeck (Munich, 2016), Schechter’s book was cursorily dismissed (Carlson, 2016), while Lunbeck’s was viewed much more favorably. While Illusions of a Future is not a study of narcissism as such, it is very much concerned with the ways that psychoanalytic theory, and especially the theory of narcissism, is used. Schechter, a medical anthropologist by training, was a candidate at the Chicago Institute for Psychoanalysis, where this research was centered. While her focus is quite different from Lunbeck’s, a subtext of both books is the way theorizing and conceptualizing narcissism influences, and is influenced by, the larger issues raised in their respective works, be it the history of the 1970s in the USA or the fortunes of a large and storied psychoanalytic institute. The ways in which this motif is developed, however, could hardly be more different.

Schechter announces the thesis of her work thus:

This book examines the development of the analyst-patient relationship as an occult object, a professional artifact that psychoanalysts at once disavow and espouse. I suggest that today’s psychoanalysts, in their effort to transcend their fears of irrelevance, play on the real relationship in a way that ends up heightening that very irrelevance. In effect, I argue, in seeking to resolve a conundrum that is central to their practice, in seeking to maintain themselves as psychoanalysts when they cannot practice what they define as psychoanalysis, they trade the real relationship against disciplinary failure. (Schechter, 2014, p. 2)

As I understand her point, Schechter is arguing that clinical psychoanalytic theory is molded in large part by the cultural context in which the practice occurs—specifically, a context in which psychoanalysis is increasingly seen as irrelevant—rather than by the progressive development of a science that more typically informs the narrative of how psychoanalytic theory has developed over the years.

Schechter also makes a claim for the specificity of psychoanalysis that seems to address observations about its ambiguity, such as Lunbeck’s description of how narcissism is defined, discussed above, or Kravis’s (2013) discussion of the analyst’s hatred of the ambiguity of analysis. Here, Schechter seems almost to be directly addressing Lunbeck’s observations on the ambiguous nature of narcissism a few pages on in her introduction, when she makes a note of “the intensification under neoliberalism of psychoanalysis’s problematic undecidability” (p. 8). For Lunbeck, the ambiguity of narcissism is a timeless feature of its existence; for Schechter, the “undecidability” of psychoanalysis is a product of its place in contemporary culture, not something inherent in psychoanalysis itself. She goes on to argue, in contrast to many critics of psychoanalysis, like Ian Hacking and Nikolas Rose, but also and for entirely different reasons in contrast to Lunbeck, that

the rationalization of psychoanalysis over the course of the latter half of the twentieth century presents a unique biopolitical trajectory precisely because of the centrality of forces and forms of disruption, both psychic and social, to the Freudian problematic: the negative, the death drive, ambivalence, the unconscious id, the repetition compulsion, the uncanny, the “beyond” (as in beyond the pleasure principle). It is the reflexive, disruptive tendency of psychoanalysis that distinguishes its rationalization from those processes of rationalization in other professions caught up in the shifts in governance characteristic of postmodernity. (pp. 9-10)

This is the most central point of the book. For Schechter, psychoanalysis is a legitimate discourse because it is disruptive of the “shifts of governance” characteristic of other discourses in our time. Further, this speaks to the disruptive nature of Ovid’s Narcissus story. It is a story about the failure of knowledge, which was also Lasch’s point when writing about narcissism. Ovid turns Plato’s injunction to “know thyself” on its head. Importantly, this is a very different kind of ambiguity from that proposed by Lunbeck. The psychoanalytic project, per Schechter, is specifically about the problematics of self-knowledge. And this is something that the neoliberal order would rather go away.

Consider, as one rather obvious example, the idea of defining emotional suffering by a series of “yes/no” answers to questions about symptoms—that is, by using the DSM as it exists today. This approach to mental health privileges a strategy for dealing with and understanding this emotional suffering in a way that inevitably satisfies the requirements of late capitalism: anything that gets in the way of the efficient workings of consumerism can be disposed of simply by changing a few answers on a checklist of symptoms. Verhaeghe’s discussion of the logic behind the symptom checklist model of the DSM (2012/2014, pp. 183-196), with its brilliant use of an analogy between the DSM model of diagnostics and the idea of diagnosing medical problems entirely as symptoms (e.g., “high fever” and “excessive sweating” as symptoms on a checklist), shows how the dominant model of psychiatric diagnosis obviates any awareness of a more complicated problem, be it the impact of extreme income inequality on mental health or the vicissitudes of life experience and unconscious fantasy in creating the symptom. In other words, the DSM is conceptually much more in the service of the economic status quo than it is in the service of any meaningful concept of mental health. As a psychiatric intern in the late 1980s, I was assigned a patient on the geriatric psychiatric ward whose symptom of loss of pleasure, or “anhedonia”—one of the cardinal features of the DSM-III-R diagnosis of major depression—was that, after years of sitting in the living room and doing nothing but watching television, she had stopped turning on the television. The fact that watching television was all this person had done for years, or other possible implications of her failure (sic) to continue doing so, was irrelevant to the assessment of this person’s condition. It also made a solution to her problem straightforward: we just had to get her to turn the TV on again.

From this perspective, the very idea of fitting in with the medical and scientific world as it exists today is highly problematic for a field that depends on its capacity to be disruptive—of the governance of society or of the individual ego—such as psychoanalysis at its inception undoubtedly was. So how can one be both a mental health professional, compelled by the rules of the profession to use the nosology and theoretical bases of our time, and a psychoanalyst? “How and why,” Schechter asks (p. 21), “in the face of a broad corporate-state-consumer demand for rationalization and accountability in health care [i.e., in the face of the demand for “evidence-based practice”] does a community of psychoanalytic practice and argumentation inhabit and expand on its own contrary demands, desires, fantasies and fetishes?” As Schechter shows us, in her several interviews with practicing psychoanalysts, it ain’t easy.

Schechter’s book is organized around these interviews. Each of her interlocutors acknowledges that there is a “crisis” in the profession, a crisis that has only grown since the 1970s—which fact makes for an interesting temporal connection to Lunbeck’s book. But, while everybody is agreed that there is a crisis, both of medical/scientific/cultural relevance and of financial viability for practitioners, there is a very wide range of ideas about what the crisis actually is. Thus, for some, it is the de-medicalization of psychoanalysis as a consequence of the lawsuit against the American Psychoanalytic Association that forced the issue of training non-physicians that led to the crisis; for others, it is the failure of psychoanalysis as a profession to provide empirical evidence of its validity that is the problem. The main focus of Schechter’s attention is a questioning of these various arguments for why the crisis exists, and how they have been used by the clinicians who make them, emphasizing the ways in which the theorizing of psychoanalysis responds to the crisis in analytic practice.

After describing the distinction between psychoanalysis and psychotherapy that was formulated by the ego psychologists who were dominant in the CIP in the 1970s (pp. 41-46), Schechter observes that “it began to appear during that era as though the medical monopoly that underwrote psychoanalytic exclusivity was, in effect, putting psychoanalysis out of business” (p. 48). This happened, she argues, because analysis had a very precise (if completely circular) definition: it was the purely interpretive treatment of patients who were defined as analyzable. Further, this definition was very compatible with a “hierarchical” division of mental health labor, with psychiatrists at the top of the hierarchy. As Jonathan Lear has observed (1998, p. 18), “In the short run, this [division of labor] allowed the psychoanalytic profession to take advantage of the powerful positive transference which the American public extended to doctors through most of [the twentieth] century.” Over time, the definition of who was analyzable and what was an appropriate analytic intervention became much less straightforward, pari passu with the increasing scarcity of analytic patients. This in turn created a new problem for the theory of analysis, as it went from rigidly defined to something else—a something else that became increasingly “undecidable”. Talking with one of her interviewees who describes herself as relationalist in her theoretical orientation, Schechter asks “In terms of how you think about analysis… what is not analysis?” (p. 69). “That’s a good question” is the response, followed by “I guess if you put it that way I can’t think of anything.” Like Lunbeck’s description of narcissism as completely amorphous, analysis itself becomes infinitely malleable. It can be anything. And, of course, a given analysis can last forever, as long as the analysand comes to at least four sessions per week. But in the process, what Schechter sees as the “specificity” of psychoanalysis, its role as a disruptive discourse, is completely lost.

It is important to note that Schechter is not arguing for the superiority of the pre-1970s model of clinical practice at the Chicago Institute. In noting, for example, that “In the era of the success of psychoanalysis, top psychoanalysts like [Maxwell] Gitelson had not needed the patient, either economically or (they believed) psychically” (p. 177), she points out another “pitfall of the business of getting a living”, a phrase she quotes from the anthropologist Edward Sapir (p. 69). The Chicago Institute was set up to maximize an idealization of the master analyst, a procedure that was highly favorable to pecuniary gain, at least for said masters, but one that was also not obviously more relevant to the “specifics” of the psychoanalytic enterprise than were subsequent theoretical developments. At the same time, the fact of the organizational hierarchy had enormous and unexamined effects on the process of psychoanalysis itself. The implications of this for analytic practice as described in Schechter’s work were profound.

Schechter concludes her book with a chapter entitled “On Narcissism”, in which she describes a trajectory of psychoanalytic theory from ego psychology to relationalism that maps onto a trajectory of analytic practice from social prestige and financial success to cultural irrelevance and less obvious material success. In the process, the analyst’s view of himself is the hidden motivation, she argues, for how practices develop: so long as the patient needs the analyst, the analyst is sufficient unto himself, with no need for the patient; when the patient does not need the analyst—and has to be “converted”, no less, to participate in an analysis—the analyst’s self is much more vulnerable. It is in the context of the fall in prestige of psychoanalysis that more than one of Schechter’s interlocutors describes their own sense of narcissistic injury.

This analytic self has, over time, become minimal, to borrow from a Christopher Lasch title (1984). In the process, the analyst has had to abandon more and more of the specificity of psychoanalysis, until finally he has had to practice in a way that merges more and more with the dominant market culture—exactly what Lasch argued happens to minimal selves under consumerism, as a matter of fact.

Schechter sums up her work thus:

As a means of governing risk up close, the real relationship is an indigenous insurance policy that makes the analyst’s vulnerability seem manageable, calculable; it is a way of spreading risk and doing so on the analyst’s own theoretical terms. If neoliberal subjectivation blends distinctions between love work, politics, and life itself, it is through such intimate, risky relationships that psychoanalysts, dreaming of security, come to imagine their world as one of uncommodified “real” care, their affective labor as a form of sociality that is prudentially able to calculate quasi-familial, “real” dependencies. I have suggested, then, that this charged relationship emerges into view in a compensatory embrace of the very neoliberal logics of accountability that lead the desiring professional to remove the sexual, the drive, the unconscious, and the paternal law of desire from psychoanalysis, mutating it in a series of self-referential, self-authorizing labors of coordination with audit culture’s ideology of the preferred provider. (2014, pp. 185-186)

It’s not a pretty picture. If this is how psychoanalysis goes, then maybe it is an illusion to imagine it has a future. That being said, it seems implicit in her entire discussion that there is a way forward that is not so illusory: to simply do the “specific” work of psychoanalysis in a way that is cognizant of and consciously resistant to the forces that have decimated psychoanalysis since the 1970s. This would be a bold and challenging move, but it would be consistent with the role that psychoanalysis had (and continues to have, in some situations) as a creative and disruptive force in the lives of our patients and in the culture at large.

Schechter ends her book by quoting one of her interview subjects in a way that is both more hopeful for a future and more specific to what psychoanalysis is: “‘It is reasonable,’ he said, ‘to expect that the fact that we are discussing the vicissitudes of narcissism will be most helpful in working through the narcissistic issues involved in the process of discussion’” (p. 187).

Liriope was told that Narcissus would have a long life so long as he did not know himself. More than Ovid taking a crack at Plato, this speaks to a profound truth exemplified in both The Americanization of Narcissism and Illusions of a Future: narcissism becomes a problem when the world, including our place in it, does not meet our (narcissistic) expectations. Both books address periods of uncertainty in self-understanding, whether at the Chicago Institute for Psychoanalysis or in the larger world of 1970s America. In both situations, how people understand themselves and their world has reached a crisis, as also happened in a different way after the Great Recession, when these books were being written. The differences in the way the two authors address the problematics of knowing oneself are instructive. I would suggest that the distinction between the “ambiguous” nature of Lunbeck’s narcissism and the “specificity” of Schechter’s psychoanalytic focus defines the distinction in the way these authors use the concept. For Lunbeck, narcissism pushes the neoliberal economy forward, as did Jobs and Welch: it’s just a question of how we look at it. For Schechter, it is the mark of our hopeless lack of self-awareness. Where does psychoanalysis as a clinical establishment stand between these two perspectives?